February 19, 2026 • 52 mins
This week, Emily and Perry tackle peptides, the purported panacea for all health ailments. Can an injection of these tiny bits of protein actually boost your metabolism, plump up your skin, heal your injuries, and overall prolong your life? And what could possibly go wrong when you inject a peptide stack of dubious origin anyway?
Plus: mRNA flu vaccines, hormone replacement therapy, and the optimal time to hoard condoms at the Olympic Village (wink wink).
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
There's a new peptide that literally burns fat off of
your body.
Speaker 2 (00:04):
At the same time it suppresses your owner.
Speaker 3 (00:06):
Peptides are one of the best ingredients you can use
for anti aging.
Speaker 4 (00:09):
Do not sleep on peptides.
Speaker 5 (00:11):
Peptides are the eight Girl of the year, and for
good reason.
Speaker 1 (00:13):
Well that's the thing about peptides. To the wolverine stack,
I don't know. If you ever get injured, get immediately
on BP one, five, seven, and TV five might.
Speaker 6 (00:20):
Help you improve your God, help the tone, texture of
your use fine lines and ring, possibly restore your where's
your natural growth? One?
Speaker 3 (00:27):
So there's truly a peptide for everything.
Speaker 2 (00:30):
Emily, are we in over our heads here?
Speaker 5 (00:32):
Maybe a little bit? How many peptides did you have
this morning?
Speaker 2 (00:35):
Are you ready?
Speaker 4 (00:36):
Well?
Speaker 2 (00:36):
I've had thirty, but it's clearly not enough. It's not enough.
Speaker 5 (00:41):
Did you have your CJC twelve ninety five?
Speaker 7 (00:44):
Oh?
Speaker 2 (00:45):
You know what, that's the problem, because that's the one
I still have my existential sense of dread, and I'm
pretty sure that's the key to eliminate that.
Speaker 4 (00:56):
I'm Emily Astro, I'm an economist and a data expert, and.
Speaker 2 (00:59):
I'm very Wilson. I'm a medical doctor.
Speaker 4 (01:02):
It's Thursday, February nineteenth, twenty twenty six, and this is wellness.
Speaker 2 (01:06):
Actually, because you're getting a staggering amount of health and
wellness information nowadays from every source imaginable, and some of
it is awesome and some.
Speaker 4 (01:16):
Of it is well actually both Fortunately we are both
people who know how to read studies, how to parse
the data, and can tell you what's worth thinking about
and what you can safely ignore.
Speaker 2 (01:29):
But before we dig in, a note that this podcast
is for educational purposes and should not be construed as
medical advice. We don't know your unique situation, so talk
to your doctor for personal health decisions.
Speaker 4 (01:40):
This week we're asking what's the deal with peptides, and
then we'll get to your question of the week. But
first let's do the health news roundup after the break.
Speaker 2 (02:02):
Hey, just a quick note from the future here. The
following conversation about mRNA flu vaccines was recorded before the
FDA reversed their stance. That's good news for everyone, as
you'll soon understand why, but bad news for our producer Tamar,
who had to add this cavea at the eleventh hour.
This is what keeping up with the news looks like,
and I think as you'll see the mere idea that
(02:23):
something is being discussed on the wellness actually podcast has
the effect of moving policy on a national scale.
Speaker 4 (02:31):
All right, Perry, So, first piece of health news for
the week is Maderna has a Phase three trial of
an mRNA flu vaccine, but the FDA has declined to.
Speaker 5 (02:44):
Review their results.
Speaker 4 (02:45):
There's been a lot of talk about this. I think
it's pretty confusing for a lot of people.
Speaker 5 (02:49):
Perry.
Speaker 4 (02:50):
Can you break down what is going on, why people
are upset? Where we go from here?
Speaker 2 (02:54):
Yeah, I mean, to be honest, this is pretty weird,
this is unusual. So why do we need an mRNA
flu vaccine? I mean the argument here is that our
traditional flu vaccines, which are those egg based vaccines, take
about six months to make, and that means you're always
sort of trying to like stay ahead of the flu
the flu eight ball, right, like, you start guessing what
(03:14):
the flu strains are going to be in the future
to grow up your vaccines. mRNA flu vaccine in theory,
can get spun up in a couple of weeks. That's
the benefit of mRNA technology. You could potentially even like
in real time, keep up with the flu strains. That
are coming out, so there's definitely a reason to do
this kind of study, even though we have existing flu vaccines.
This vaccine that Maderna put out, they had published already
(03:38):
several studies about seven thousand patients each demonstrating safety. But
this forty one thousand patient trial was for efficacy. Does
it prevent the flu compared to not a placebo but
the current active flu vaccine, one of these egg based vaccines,
and in fact, the rates of flu were significantly lower
with the Maderna vaccine. They submit that data to the FDA,
(04:00):
and in theory, an FDA advisory panel will review it,
assess it for safety and efficacy, make a ruling that
the FDA then decides on. This did not happen. The
head of the Vaccine Division essentially of the FDA, guy
named Na Prosad, apparently according to New York Times, unilaterally
decided not to review this data at all, so not
to bring it to the peer review group in the
(04:22):
first place. His rationale was that the dose of the
normal vaccine they gave was not high enough for older
people who's who do better with a higher dose, so
it was like not a good enough comparators. The argument.
Here's the problem. If you're a big pharmaceutical company, generally
you go to the FDA and this is what Madarna
(04:43):
did before you do the trial, and you say, hey,
here's our design, here's our control group, here's our analysis.
Are you okay with this? Because you don't want to
spend two hundred and fifty million dollars if the FDA
is going to say they're not okay with this, right,
So they did that. They went to the FDA. The
FDA said, sure, run your trial. You know, this looks
like a good design. And now apparently one person, although
(05:06):
obviously who knows what's going on, has after the fact
been like, no, you know, moving the goalpost. This is
like sort of classic Lucy picking up the football situation.
Speaker 4 (05:17):
Yeah, I mean it is important to hit on the
top point of like why we would want this vaccine,
And I actually think it's particularly interesting in the context
of this most recent flu season where the flu vaccine
was very poorly matched to the circulating flu strain because
they guessed what the circulating strain would be six.
Speaker 5 (05:34):
Months out and they were not right.
Speaker 4 (05:37):
And the promise of the mRNA version of this is
you wouldn't have to guess six months out, you could
guess a month out or two months out, and you
might get much closer. And so I think there's a
lot of value here making the fact that now it
seems like this just won't happen both objectively bad. In
addition to this process seeming like this definitely isn't the
(05:58):
process that we would like, we're already starting to see
companies talk about, you know what I want to do
vaccine innovation now if there's no way it's going.
Speaker 2 (06:06):
To mRNA innovation in general. And you know, m r
and A technology is not just for vaccines. There's there's
m RNA anti cancer therapies and stuff that are getting
held up by this, and it does feel somewhat ideological.
I think all people are asking is like, just do
the normal process, like just submit the data for the
standard peer review that every other drug gets through. That
it's not happening.
Speaker 5 (06:27):
It is a holdover from COVID.
Speaker 2 (06:29):
All of society has long COVID. Right now, basically, all right,
let's stick with the FDA. Emily, maybe some better news.
I'm curious what you thought of this. The FDA had
removed some warnings that appear on hormone replacement therapies for
women who are perimenopausal or postmenopausal. In the past, those
(06:51):
medications had warnings on them that they could increase the
risk of cardiovascular disease, breast cancer, or dementia. Those warnings
are now removed. Good bad.
Speaker 5 (07:01):
I think this is great news.
Speaker 4 (07:02):
I mean, so hormone replacement therapy is really beneficial for
a lot of people in perimenopause and in menopause. It
can improve just quality of life tremendously lower symptoms which
can be really debilitating. There was a large trial decades
ago which suggested that there could be some risks from
(07:24):
hormone replacement therapy, but as people have better understood that
data and gotten follow up data, it has seemed pretty
clear that the risks that were identified in that trial,
which were mostly about cancer, in fact, are not things
that we should be concerned about for the vast majority
of people who would be treated with these medications, and
(07:44):
so we've kind of overtime clawed back towards a view
that actually HRT should be prescribed more that can be
very beneficial, and the removal of these boxed warnings is
the sort of the next step in that. So My
hope is that this will encourage more people who could
benefit from these therapies to be on them. So I
thought this was a response to evidence, and a good
(08:06):
one at that are so.
Speaker 2 (08:08):
Good the FDA gets it right from time to time.
I want to move on to a bit of happier
news something. You know, I've seen this story before, but man,
I always love it. The Olympic village condom situation. So
the New York Times reported that the Winter Olympics village
(08:30):
in Italy they ran out of ten thousand condoms within
three days. To put that in perspective, there are about
three thousand athletes in the Games. That's a lot of condoms.
Speaker 8 (08:45):
A lot.
Speaker 2 (08:45):
I just have to say. It must be fun to
be in like the best shape of your life.
Speaker 5 (08:49):
And in Italy, I agree, I mean I do.
Speaker 4 (08:52):
I did wonder whether there was a condom hoarding issue, right,
So you know, my guess is that people mostly before
their events are kind of like laying low, but maybe
they're picking up a bunch of condoms for like after
the event, and.
Speaker 2 (09:06):
Oh do you think and they've got that like overly
ambitious like I'm gonna need twenty.
Speaker 5 (09:11):
What if I get a gold medal.
Speaker 4 (09:13):
I'm gonna need a lot of condoms for all of
the demand that's going to be coming in after my medal.
Speaker 2 (09:18):
So I was debating this with some people. You think
that you are outspeaks somewhat euphemistically. You think you are
not using the condoms before your event.
Speaker 1 (09:29):
Don't.
Speaker 2 (09:30):
And I'm wondering if there's some events, like maybe biathlon
or like some of the precision events, where you should
be using the condoms more beforehand.
Speaker 5 (09:39):
It's an interesting thing.
Speaker 4 (09:40):
Yeah, I I in my mind, I have the endurance
events where I do think you probably don't want to
be using the condoms before, but.
Speaker 5 (09:48):
I maybe the precision maybe like curling hills.
Speaker 4 (09:50):
You out curling, yes, curly really clearly curling would benefit
from a pre condom preuse.
Speaker 2 (09:58):
There you go, curlers, let us know. Hit us up.
We want to know what your strategy is.
Speaker 5 (10:04):
I really, really really do.
Speaker 4 (10:07):
That's it for the health news of the week. Next up, peptides,
but first.
Speaker 2 (10:11):
A break, Welcome back to wellness. Actually, so, what's the
deal with peptides? Emily? This is like a big topic.
There's so much talk about this on social media. It's
(10:31):
nearly overwhelming.
Speaker 4 (10:33):
I was waiting for the airplane yesterday for a flight home,
and I opened up my Instagram and the first thing
I saw was someone who had two side by side
pictures of her face, and it was like, it was like,
this is what happens after twelve weeks on peptides, and
she looked better. I mean, I don't know that that
particular person. I have a lot of issues, but the
(10:54):
point is that you cannot open social media without hearing
about peptides. I would like us to start this by
just demystifying a little bit, you know. When I think
about peptides the thing, at least before I did some
more research for this episode, the first thing that often
comes into my head is Demimore in the substance, you know,
(11:14):
where she takes something and then she like turns into
a different person and then slowly decays over time. I
don't think that's what it is, but my concern is
that for many people, we're close to that in our
understanding of peptides is just this seems like a crazy
thing with a lot of crazy names that people are
yelling about on Reddit.
Speaker 5 (11:33):
So can you just like anchor us in the biology
of what is this?
Speaker 2 (11:39):
Yes, yes, it does not make hot young women pop
out of your back, at least not yet.
Speaker 4 (11:46):
We haven't rounds of peptide for that is my guess.
Speaker 2 (11:50):
Let's talk about that. Okay, So the first thing you
have to know is what a protein is. So protein
is the building blocks of our bodies. And protein are
composed of little building blocks which are called amino acid.
There's about twenty that humans use in our proteins, and
they're all different, but they all stick together, just like
(12:11):
lego blocks all do. Right. They have one end and
the other and they kind of fit together. And you
can take those twenty amino acids and combine them and
any combinations that you want to make various proteins. Now,
proteins can have, you know, thousands of amino acids. They
can be very very complicated. Peptides are little pieces of proteins,
(12:32):
and the definitions vary, but most people say that peptides
are somewhere south of fifty amino acids. So you're talking
much much smaller than a protein, but you're still using
those same twenty amino acids. And just to explain why
Reddit and Instagram like has an explosion of all these
things with you know, these crazy names and numbers attached
(12:55):
to them. If you want to do the math. Okay,
if you have twenty amino acids that you can combine
into a chain of fifty, the possible combinations, and I
had to get out my scientific calculator for this, the
number of different peptides you could create is the same
roughly as the number of atoms in every star in
(13:18):
our galaxy. Okay, there is a nearly infinite possibility of
the number of peptides that are out there.
Speaker 4 (13:28):
Okay, so we've got these peptides, potentially an infinite number
of them. But I think that the question is why
would having more.
Speaker 5 (13:37):
Of some peptide.
Speaker 4 (13:38):
I understand, we have amino acids, they make peptides, they
make proteins.
Speaker 5 (13:41):
We need those.
Speaker 4 (13:43):
Why would supplementing myself with some peptides have any impact
at all on anything?
Speaker 2 (13:50):
Oh? Sure, Well, so peptides. You know, if you have
a chain of amino acids, what's going to happen is
they're going to fold into like some kind of shit
based on their chemical nature. So these are not like
a long stack that's just aligne based on what the
amino acids are. They kind of fold and shape into
like little globby shapes, which is how your body signals
(14:15):
to do stuff in a lot of ways. So there
are receptors for different shapes on your cells, and different
peptides at least purportedly will stimulate certain receptors, and those
receptors tell your cells what to do. So it's almost like,
you know, you can imagine a key and lock analogy
or something. You have these locks on your cells and
you're trying to inject something that's going to form the
(14:36):
key to open the lock. That's the theory at least.
And a lot of these peptides, while based on proteins
that you can ingest or that exist in your body,
not all of them are you know, some of them
come from animals, some of them are completely synthetic.
Speaker 4 (14:54):
And so the ideas if I had more of some
of these peptides, I could encourage my cells to do
more of something that I want. So I think a
good example that probably anchors for people is the glp
ones are peptides.
Speaker 2 (15:06):
Yeah, classic, so.
Speaker 4 (15:07):
Smaglutide, t receepetite, these like things that people are taking
for weight loss. Those are peptides They are injected and
then they are encouraging something that then causes you to
be less hungry and have all kinds of other impacts.
But it's just a it's just a peptide to try
to get your body to do more of something which
it might do otherwise, but you.
Speaker 2 (15:28):
Want more of it exactly. And just to give a
sense of like the diversity of peptides, I've told you
there's infinite, but because the shape is really what dictates
the function of molecules in your body. Here's some other examples.
So glp ones you said, aspartame the artificial sweetener, okay,
like in diet z. Yeah, I'm not sure which one
(15:49):
is in Die Cooke, but yes, like you know the
one that people actually a lot of wellness influencers are
worried about aspartain is a peptide. It's two amino acids
stuck together. They just happen to make a shape that
stimulates the sugar receptor on your tongue. So it just
like makes you think it's sweet, but it's not. It's
just a peptide. B venom for example, the maion protein
(16:09):
and b venom is called meltin and that's a peptide.
So that can be something that really hurts when you
inject at for example, right, and so one of my concerns,
and actually i'd like to play you a clip, is
people suggesting that peptides are really safe because of their
sort of nature of being something like a protein. So
(16:30):
take a listen to this.
Speaker 6 (16:32):
Peptides are sequences of amino acids. And why is that important?
Because your body recognizes these, it can break them down.
They're called metabolites, and it can get rid of the waste.
When we put chemicals, synthetics, and pharmaceuticals into our body,
there's no natural way for our body to break them
down and get rid of them.
Speaker 2 (16:48):
So emily here we have you know, someone be like, hey,
these are just amino acids, Like your body knows what
to do, that therefore safe. What do you think.
Speaker 5 (16:59):
That doesn't sound right to me?
Speaker 4 (17:01):
I mean, I think you know there the fact that
something is naturally occurring in the world and is an
amino acid definitely does not mean that it is safe.
Speaker 2 (17:09):
It clearly doesn't. Right, Like snake venom has peptides in it, right,
There's lots of things. But I think people one of
the reasons that peptides are exploding, and actually one of
the regulatory reasons you can get your hands on these
things even is because of this idea that like, well,
they're just made of amino acids after all.
Speaker 4 (17:29):
Right, all right, so let's talk about whether these actually
matter for anything.
Speaker 5 (17:34):
And I actually want to start with a place where.
Speaker 4 (17:36):
I think the evidence is the best, which is in
the space of collagen. So I hear people talk about
collagen peptides both for your face and for your joint health.
So this comes up actually a lot in endurance sports.
People talk about, you know, you like, I need my
joints to not be so elderly and creaky, and so
I should take these collagen peptides in a lot of
(17:58):
endurance sports drinks.
Speaker 5 (18:00):
It's a thing.
Speaker 4 (18:01):
And so my sense is that the evidence on this
is at least reasonably good in the.
Speaker 5 (18:08):
Case of your skin.
Speaker 4 (18:11):
So we have some meta analyzes of trials in which
you know, using collagen peptides, typically in a kind of
topical way, can have significant improvements in your skin hydration
and elasticity. Now, okay, in that particular meta analysis, there
was there was a subtlety, which is that when you
(18:32):
only looked at studies that were not sponsored by industry,
the effects were not there so capitalism. But I'm curious
whether you, like, if you were interested in improving your
already lovely skin elasticity, would you use a collagen peptide.
Speaker 2 (18:48):
I mean, maybe I don't care that much about it,
but you know whatever, I'm a I'm a forty six
year old man, so I know that there are some
there's some different opinions here. I mean. The interesting thing
aboutologen peptides is that they're basically the only peptide to
exist in a regulatory landscape that makes it easy and
safe to get because the FDA has recognized that collagen
(19:10):
itself is safe. They call it generally recognized as safe,
which means you can be a supplement company and you
can put collagen in a pill and you can give
it to people. Collagen peptides all it is is they
take collagen and they digest it with an enzyme. So
collagen is a big protein with you know, thousands, literally
thousands of amino acids, and then they just digest it
(19:31):
down into kind of manageable pieces, very similar honestly to
what your digestive system does when you eat a big protein.
But that said, the collagen peptides are because they're smaller,
absorbed through the skin, a little bit better, absorbed through
the GI tract a little bit better, and you're delivering
in that sense, you're delivering some of these proteins, some
of these constituents of the stuff that makes your skin,
(19:54):
you know, firm and elastic, directly to the site that
you want them to be delivered. And to me, that
seems fine. You know, this is one of those things
I tell people Listen, it's not terribly expensive. If you
feel like trying to try it, you know, try to
be honest with yourself if you think you really look
better if you don't, save your money.
Speaker 5 (20:11):
Yes, save your money.
Speaker 4 (20:12):
Perhaps good advice in general in everything we hear about
on social media. So beyond collagen, I think there are
actually a couple of other things where a couple of
other FDA approved peptides which treat actually.
Speaker 5 (20:26):
Someone unusual things. So one of them is for.
Speaker 4 (20:33):
Tanning and one is for improving female sexual desires.
Speaker 5 (20:38):
I get that right, sort of.
Speaker 2 (20:40):
Yeah, the one for tanning called Atha melanotide. It's not
FD approved to get you tan. It does, but it
does get you tan. It's approved for a very rare
condition called erythropoetic proto porphyria, very few people have, but
it does stimulate the melanin receptor, which is what makes
(21:01):
you tan, and so people who receive this drug do
get tan. And it's worth thinking about just because there
is a pathway for peptides to go through the same
approval process that every other drug has to go through,
the same purity standards, the same testing, the same manufacturing practices,
and they can do really interesting things like it's true
at the female hyperactive sexual desire disorder, which emily this
(21:24):
we definitely need to do a whole show about this
because it's fascinating. That's a peptide product called vleisi which
was approved to treat this condition. It does apparently increase
sexual desire in women. It also causes nausea in forty
percent of people who take it, which I don't know
how those two things are compatible, but apparently they are.
Speaker 5 (21:47):
Well, you don't know, it could be the sixty percent
of people who are not nauseous. You know, it's straight
up fair enough.
Speaker 2 (21:52):
Yeah, it's your flipping an interesting coin there, And of
course we should. You mentioned already the GLP one receptors
aretides and insulin, which is you know, maybe saved more
lives than any other injectable drug that we've ever created.
Is also a peptide product. So there is a pathway.
But I think there's a lot of people who are
(22:13):
trying to kind of jump that evidence gun and potentially
taking on more risk than they know that they are
taking on.
Speaker 4 (22:20):
What about the evidence on joint pain, Most of this
evidence is in athletes, some of it's in older people.
Speaker 2 (22:26):
Yeah, it's there, it's there. I mean, so we do
have another meta analysis, and for everyone, a meta analysis
is just a study of studies. So it's a study
that aggregates data from multiple other studies that have been
done to try to kind of average out the variability
and things like that. There was some evidence in this
meta analysis of fifteen randomized trials of collagen peptides for
(22:49):
joint pain, twelve of which were in athletes that showed
some improvement in joint pain, that there was really no
evidence for muscle building, which is the other thing that
people sometimes suggest this being u used for. Again, one
of the problems we have when the outcome of a
trial is subjective, like pain or fatigue or even depression.
Speaker 5 (23:11):
How your skin looks.
Speaker 2 (23:13):
How your skin looks is that it is very susceptible
to what we call placebo effects, like the idea that
you're taking something. Now randomized control trial is going to
have placebo controls. But just even because you have a
placebo doesn't mean people can't figure out what they're getting.
Sometimes they taste a little bit different, they look a
little bit different, things like that. So you know, again
(23:35):
for joint pain, it's like it's relatively safe, it's not
going to hurt you. It's they're non toxic. If it helps,
that's great. I mean, I don't even care if it's
a placebo, right Like, if it helps, and then feel
like it helps, you feel like it helps, it helps,
go for it.
Speaker 8 (23:49):
Yeah.
Speaker 4 (23:49):
I mean this is an example of a place where
I think we sort of bring together, like often what
we're looking for, and we try to argue for causality
the question of like is it biologically plausible? I think
the answer in the collagen peptide case is yeah, it's
biologically plausible that.
Speaker 5 (24:05):
You know, this could have some this could make some difference.
Speaker 4 (24:08):
And then we're looking for, you know, do we have evidence,
either randomized evidence or even observational evidence. But here it's
randomized that suggests that we do see some impacts.
Speaker 5 (24:19):
I will say I take away from this like this
is small.
Speaker 4 (24:22):
Yeah, there are many other things one might do to
address joint pain, like strength training and other things where
collagen could be like a little helpful, but.
Speaker 5 (24:30):
Is probably not the be all and end all.
Speaker 4 (24:33):
And sort of similarly, my guess is the overall variation
in skin elasticity across people is much greater than the
treatment effect of a collagen peptide. Like when you see
someone on the Internet and their skin is amazing and
they tell you they took collagen, I'm telling you it's
that they have good genetics and or are using a filter,
(24:56):
not that they are taking collagen and.
Speaker 2 (24:58):
Are really good at makeup. When I was looking at
all the peptide stuff on Instagram and things, these videos,
all I was like, oh my god, these people are
just beautiful. Like that's the that is the requirement. Apparently
to be an influencer is to like look really good
on camera, you know, which is why I'm glad this
is an audio podcast. No one has to look at
(25:19):
my unfiltered face.
Speaker 5 (25:22):
Everyone will love it.
Speaker 4 (25:23):
Okay, so let's talk about the sort of third piece
of the peptide conversation, which is the idea of using
injected peptides for like longevity, wound healing.
Speaker 5 (25:38):
And this is a much.
Speaker 4 (25:39):
Bigger space than the narrow like I'm taking some mythologen
to improve my face. It's like, you know BPC one
fifty set. It's there's a thing called the wolverine stack. Basically, Perry,
there's a thing called the wolverine stack. And I guess
do we want it?
Speaker 5 (25:55):
Say more?
Speaker 2 (25:56):
Well, okay, Emily, let's take it from the highest authority
in the land, Joe Rogan himself.
Speaker 1 (26:04):
Well, that's the thing about peptides to the wolverine stack.
BP one five seven and TV five hundred.
Speaker 7 (26:09):
I don't know.
Speaker 1 (26:09):
If you ever get injured, if you ever get injured,
get immediately on BP one five seven and TV five hundred.
Speaker 2 (26:14):
I didn't hear about TV five hundred.
Speaker 1 (26:16):
What's that one thymuson BETA five hundred. Yes, in conjunction
with BPC one five to seven, it is a phenomenal
stack and just really helps injured.
Speaker 8 (26:25):
I don't know.
Speaker 2 (26:25):
They called it the wolverine that's.
Speaker 1 (26:26):
What they call it. The wolverine staling. Yeah, because you
heal incredibly well, like you like quickly, I was talking
to pro football player pulled his hamstring. It's like, dude,
I shot that right into my hamstring for two weeks
and I was right back on the field. Wow, I
was like, that's nuts.
Speaker 2 (26:39):
So, first of all, Joe Rogan, Ben Affleck, Matt Damon
in that clip, I mean, we are really blowing against
the wind. I mean, I don't know that we can compete.
Speaker 5 (26:50):
No, totally not. I mean that, yeah, all right, but.
Speaker 2 (26:53):
Let's let's let's I think BPC one fifty seven because
of Joe Rogan honestly, and the Wolverine stack is BPC
one fifty seven combined with TB five hundred, which is
another injectable peptide. I think it's really emblematic of the space.
And so no, we are not. I have to apologize
to our listeners. There are like hundreds and hundreds of
marketed peptides out there. We just simply can't get to
(27:17):
all of them and like whether they work and how
they work. But I think there's some real big principles
here that BPC one fifty seven sort of teaches us.
So let's start there and kind of kind of walk
through it totally so BPC one fifty seven, this is
a peptide that was initially isolated from human gastric juices,
(27:38):
which is weird, okay, but fine.
Speaker 5 (27:41):
You know, as you said, you can get peptides from anywhere.
Why not from your ass rod juices?
Speaker 2 (27:47):
Sure? But you know, because it's being promoted for healing
and everything. You kind of I was like, oh, it
must have been isolated from like healing cells or something whatever,
But you know, hey, the gastric mucosa is a hostile environment,
so so maybe there's some biologic plausibility there. The data
for BPC one fifty seven is essentially entirely in mice
(28:08):
and rats, So you injure a rat like use sever
This is cruel a little bit, but this is how scientific.
Speaker 5 (28:16):
And rats and mice in is corol.
Speaker 2 (28:17):
So I know, so trigger warning for pet rat owners.
They will like sever part of a rat's achilles tendon
and then you know, they either inject this stuff or
they inject a placebo and then they see how fast
the achilles tendon heels. And some of those studies and
mice and rats do show accelerated healing with PPC one
(28:38):
fifty seven.
Speaker 4 (28:39):
Okay, I just want to pause on the question of
mice and rat studies because I feel like a tremendous
amount of the data that we have in the world
about all kinds of different treatments come from mice and rats.
Because mice and rats are really easy to experiment on.
You can do all kinds of stuff with them, like
cut their achilles and do other things, and look in
(28:59):
their brains and kill them and do all kinds of
things which may be said but are effective for learning.
And we always then have the question of how do
we take the evidence from mice and rats into humans.
And you know, there there I think are really good learnings.
But someone said to me the other day, you know,
if we were mice, we would have solved like everything,
(29:20):
because actually in mice, you know, you can really titrate
and be careful, and there's a lot of things that
work in mice. But then when we bring them into humans,
it doesn't work, or the effect size is totally different,
or just this doesn't port over.
Speaker 2 (29:33):
Yeah, we're just not the same creatures. But there's even
bigger issues than that, particularly when it comes to the
longevity space, because mice and rats don't live as long
as people in their natural states. You know, mice might
live a year or two, rats might live a little
bit longer. But you know what, in these research studies,
they're not letting these mice live to a ripe old age, right.
(29:56):
What you do is, you know, you do your little
Achilles tendon thing, and then you watch them for a
couple of weeks as they heal, and then you the
euphemism is sacrifice the mice. You know, humanly, that's the euphemism.
That's the euphemism is sacrifice. You kill the mice in
as humane way as possible, and there are protocols for that.
And then and then you know, you can extract their
(30:18):
organs and look them under the microscoop and do all
that stuff. So even if we're like, oh, yeah, this
appears to heal Achilles tendons, the larger scale questions of
like what happens if you're doing this repeatedly on a
weekly basis for years and years and years, like, we're
not even close to knowing that, And there are some
concerns here. So BPC one fifty seven. Thanks to the mice,
(30:40):
we know a little bit about how it might work.
Aside from the general magic of being a gastric juice
peptide BPC one fifty seven appears to bind a receptor
called VEJEFF, or vascular endothelial growth growth factor, which promotes
the growth of blood vessels into tissues. And sure that
makes sense. If you're talking about healing, you want a
lot of blood flow, Like, that's no doubt a good thing.
(31:02):
One of the problems. Actually, you probably can guess the
problem memory, what's wrong if we promote blood vessel growth
into tissues too much?
Speaker 4 (31:12):
I actually I feel like this is like when my
fourteen year old asked me about her biology homework, and
I feel like, no, I don't know.
Speaker 2 (31:21):
Cancer is begging for blood vessels to come into the tumors,
and one of our main therapies to treat cancer is
blocking VEJEF because it turns off that signal that the
cancer saying like, ooh, give me blood, grow blood vessels
into me, and then the cancer starves and dies. And
so there is a theoretical concern that's, you know, ongoing
stimulation of receptors like this could lead to cancer. And
(31:43):
we have no idea if that's true, because you kill
the mouse, you know, a week after you give the injection.
So just something to be aware of there.
Speaker 4 (31:50):
When we look at this particular thing in people, I
would say my read is that, like, we don't have
much evidence in any direction that this is effective in people.
We don't have any randomized control trials, we don't have
a lot of just we just don't have anything.
Speaker 2 (32:05):
Correct, only anecdote, which is unfortunately the problem.
Speaker 4 (32:08):
Yeah, yeah, anecdote is not data. I mean, this whole space,
this Wolverine stack, all of the other stacks.
Speaker 5 (32:16):
The different things, really has the feel of like there's
an interesting potential something to explore based on the animal data,
but nothing in the people data that would say they
should be widely adopted based on efficacy foundation. And then
we are worried about, you know, some of the potential
(32:38):
risks to using such a treatment.
Speaker 2 (32:41):
Absolutely right, and I think that's the prudent point. But
we also have to realize that a there are a
lot of people out there that are potentially suffering with something,
and a lot of times the medical establishment that I
am a part of does a poor job of this. Right,
They've got joint pain, they have something, you know, yes, sure,
they were told to do physical therapy, they're told to
(33:02):
do strength training and things just aren't working. So there's
a desperation there, like this does fulfill a need that
I think some people have. And then there's a whole
group of people, you know, the kind of biohackers who
are like, yeah, yeah, I understand in theory that we
would like to have a large, randomized trial to prove
that this works, but I'm not going to wait for that.
Like this stuff seems great. My buddy says it's great.
(33:22):
This guy online says it's perfectly safe, you know, LFG Like,
let's go, and I'll sort of throw caution to the wind.
And I think as much as we can say, like, well, guys,
I don't know, there's no hard data. It's it's still
going to happen. And so I think, anticipating that this
stuff is out there, we might want to try to
give people some like tools to be able to separate
(33:45):
at least what is potentially safe from what is potentially
not safe, even if we throw evidence out the window.
Speaker 4 (33:52):
Yeah, so I want to start with actually the just
noting that the Okay, so let's kind of back up
there the way we think about peptides. There are some
peptid that people take orally other than some of these
collagen peptides. Generally, oral peptides are totally ineffective because they
break down in your stomach and are not therefore absorbed.
So if somebody is telling you here are some gummies
(34:14):
with this amazing peptide, like that's just a money toilet,
Like you're just putting your money in a money toilet
and flushing it away, correct.
Speaker 2 (34:22):
I think broadly, yes, there are ways to make peptides
more stable in the GI tract. Oral peptide consumption is
basically going to be safe, you know, even if you
are ingesting like b venom.
Speaker 4 (34:34):
Because it's not effective. It's it's safe because it's useless.
Your stomach is eating it.
Speaker 2 (34:39):
Correct, And so so I don't worry too much about people,
you know, wasting their money on things. You know, I'm
a libertarian in that sense.
Speaker 4 (34:48):
No, I will say I worry about that because I
feel like, exactly to the point you had before, which is,
you know, people are struggling with this, they want to
get help, and then online someone's telling them, oh, just
take this gummy be venom and like it's going to
fix all of your of your problems. I actually think
that really gets in the way of people finding solutions
that might actually work for them. So I am more
(35:09):
worried than you are about the kind of I'm buying
this unapproved thing that somebody on TikTok told me about,
even if it is not actually unsafe, although I agree
with you, it's worse if there's a potential safety risk.
Speaker 2 (35:20):
Yeah. I mean, the trick here is being honest with
yourself and really trying to determine whether this thing that
you tried, if you're going to try it, helped you
or not, Like is your life better or not? Is
it worth the expense or not? We think I agree
with you it probably isn't most of the time, Okay.
Speaker 4 (35:37):
But then there are these products that you're injecting.
Speaker 5 (35:40):
So most of these peptides.
Speaker 4 (35:42):
Would be delivered to the extent they could be efficacious
at all. They are delivered through an injection like a
JLP one, But these, unlike the GLP ones, are not
in an FDA approved product category. So generally the FDA
does not approve these peptides, which are made by compounding
pharmacies and are not regulated because the FDA has actually
(36:07):
now said they are illegal to compound. That includes this
BPC one fifty seven and all of these other ones,
and so if you're getting these, they are not from
an FDA proof supplier.
Speaker 2 (36:17):
I think this is such an important point, and I
want to play a clip here about someone who's trying
to talk about safe sourcing of peptides.
Speaker 3 (36:27):
So today you and I are going to have a
little chit chat about where you're getting your peptides from.
There are a couple different ways that you can get
your hands on peptides. One is going to your doctor
and getting a pharmaceutical prescription for its option number two
compound pharmacy. But there are two split offs that come
up when we talk about compound pharmacies. So one is
going to be pharmaceutical grade, human grade, made for human beings.
(36:48):
The other is research grade. This is the one that
I am telling my clients to stay away from. There's
not the same amount of oversight.
Speaker 5 (36:55):
We don't have their party.
Speaker 2 (36:56):
So I really do think because you know, if you're
listening this and you're like, well, I don't know, Joe
Rogan says, BPC one fifty seven is good, Like I
want to get some my hands on some BPC one
fifty seven. It is important to know what the regulatory
landscape is here. Compounding pharmacies are pharmacies that have a
license to mix drugs. That's what compounding is. They can
(37:19):
make their own concoctions under specific conditions, ideally sterile conditions
that they can then sell for injections and things like that.
Compounding pharmacies are regulated at the state, not the federal level,
which gives this whole crazy patchwork of what's legal across
the country. And because you can ship these things from
state to state, it basically is like a lowest common
(37:41):
denominator of what the compounding pharmacy can do. Many of
the peptides that you'll see out there on Instagram are
able to be made in compounded pharmacies, but many of
the most popular ones, as you said, Emily, are not.
So BPC one fifty seven, this Wolverine stack peptide out
of Joe Rogan fame was classified by the f as
a Category two substance, which is one that has significant
(38:03):
evidence for harm. And compounding pharmacies are not allowed to
synthesize or create anything that is Category two, where they
lose their license that's illegal. So if you're getting BPC
one fifty seven, you're actually not getting it from a
compounding pharmacy. You're getting it from overseas almost certainly, and
most of it comes from China. So again, BPC one
(38:26):
fifty seven, I think is like the poster child for
this set of problems. It's marketed aggressive. It's got a
I mean Wolverine stack like that is amazing, totally awesome,
like I'm a superhero fan, like that is great marketing.
It's got really impressive influencers talking out like two with that.
I mean, I would do it. I would do it
if you show me. You've got these impressive influencers talking
(38:48):
about it. You have, you know, anecdotal evidence from anecdotal stories,
i should say, from people saying how great it is.
But it's actually like deemed unsafe. You have to source
it from some external kind tree and we have no
idea what its actual effects are. And that's sort of
the space right now. It's like it's pretty much the
wild West, and when it comes to eating something, you know,
(39:08):
I'm more experimental when it comes to injecting things into
your body, like you don't really want the wild West.
Speaker 4 (39:13):
Yeah, I mean, there are all kinds of examples in
the past of things.
Speaker 5 (39:18):
That were injectable that turn on bad.
Speaker 4 (39:20):
I was looking at this Scientific American article from a
number of years ago about stem cells where someone had
like injected some stem cells to try to fix some
eyelid problem and they ended up growing tiny bones in
their eyelid which need to be removed.
Speaker 5 (39:33):
I'm not saying that's going to happen here.
Speaker 2 (39:35):
That is worse than the substance.
Speaker 5 (39:38):
It is somewhat worse. I know you may not have
watched the substance.
Speaker 4 (39:42):
It's pretty much, but I mean, I feel like there
is a general sense that injecting yourself with things it
runs a risk of infection, and it is just a
much more extreme approach to this than say eating something,
which again I don't think that sense in this context
for almost any of these peptons.
Speaker 2 (40:03):
Let me give you two more risks of injecting things
into your body is if we don't have enough Number
one allergy. As you may know, when we eat things,
we have this whole immune system in our gut that
surveils them for allergens and gives us tolerance to the
things we eat. This is why, like Emily, I'm sure
you've talked about it's actually good for little kids to
get kind of dirty and put dirt in their mouths
(40:25):
and stuff like that so that they have less hypothesis
allergic reactions. Right, that's what our gi TRAC does. When
we get what are called antigens, which are peptides or
proteins or other things via another route like the injection
or sometimes the inhalation route, a whole different immune reaction occurs,
and that is an allergen forming immune reaction. It is
(40:46):
worth noting that the first time you get stung by
a bee is not when you have the anaphylactic response
to a beasting if you're allergic to bees, it's the
second time. The first time the allergy starts to get
learned and will up essentially, and then the second time
you get stung you have the anaphylactic shock. As I said,
there's infinite peptides you could theoretically inject into you, and
(41:08):
it is likely that some at the very least will
cause severe allergies in some people. To be aware of that.
Number two is what we call autoimmunity. So your immune
system is this amazing thing that surveils all the cells
in your body and decides is this me or is
this something else? And in general, if you're healthy, it
(41:28):
looks at your cells and says, oh, yeah, this is me.
I don't need to attack this, this is myself. We're okay.
Autoimmunity is when the immune system starts to recognize something
in your own body that is you, but it doesn't
recognize it as you anymore, so it attacks it. And
you know, lupus, for example, is the prototypical like autoimmune
syndrome where your immune system is attacking these various cells
(41:49):
in your body. When you inject a protein into yourself,
you form antibodies to that protein. That is how vaccines work.
When we inject a covid vaccine, antibodies form against the
spike protein and that works because the spike protein is
not you, and so when the immune system sees the
spike protein again, it can attack that. Many of these
(42:12):
peptides are derived from human proteins, and if your immune
system starts to recognize those peptides as foreign, there's a
chance that they might start to attack your own proteins
that contain those peptides as foreign, and that could be
really bad. It could almost do the opposite of what
you want these things to do, right, because you want
these peptides to stimulate this system, and now all of
(42:35):
a sudden you have antibodies that are directly attacking the system.
That could be an issue in the long term.
Speaker 5 (42:40):
It does seem like an issue in the long term.
Speaker 4 (42:42):
Okay, so Perry, I honestly feel like we could just
list all of these peptides that exist in the world
and just talk about why there's no evidence for them.
You know, there's TB five hundred, there's g hkcu. There
are a million of these peptides. And if we talked
about everyone speaking nearly all cases, what we would say was,
(43:04):
you know, maybe there's a little bit of suggestive something
in mice, and there's nothing to say in people. And
there are these risks of injecting yourself with random things,
which you want to be careful about. So I do
want to acknowledge the people who are listening, who are like,
I hear you about this, but it sounds good. I'm
(43:24):
interested in trying. And so if someone came you know,
you're doctor, somebody comes to you and they're like, look,
I'm really interested in trying to inject myself with a
bunch of different peptides. I just feel like it's like,
that's that's for me this week. Is there any way
to ameliorate some of the concerns that you have about
such activities?
Speaker 2 (43:45):
Yeah, I mean, so you know, you're probably not going
to get them from me directly because I don't think
the risk benefit calculus is there. But yeah, just to understand,
let's accept the fact that people are going to do this, like,
you know, we cannot fight the tides.
Speaker 5 (44:00):
The apple that comes to you and ask for some advice.
What's the advice?
Speaker 8 (44:02):
All right?
Speaker 2 (44:04):
Ben? What was up with Geeli? Did you need to
do that?
Speaker 7 (44:06):
Like?
Speaker 2 (44:07):
Was she pressure you? Okay? If you're going to do it, okay,
realize that if someone tells you that they're getting some
of these peptides like GPC one fifty seven from a
compounding pharmacy, they're not. It's not legal, so it's coming
from outside of the US, So be a little skeptical of,
you know, wherever you're getting them from if you are
getting there. And there are places that do a better
(44:28):
job of trying to be reputable in this space, and
what they do is they farm out the substance to
an independent testing laboratory, which issues what's called a certificate
of analysis, which basically says like, we tested the stuff
in here, and yes, it is what it says it is.
The things you're looking for on a certificate of analysis.
(44:49):
Number one is purity. Is it actually you know? Is it?
Is it clean? Is it the stuff you want? You
want basically greater than ninety eight percent purity to feel comfortable.
Number two, you want testing for something called endotoxin. This
is a bacterial byproduct that causes sepsis and inflammation. You
do not want endotoxin in anything you inject into your body.
(45:09):
It's also the thing that causes toxic shock syndrome. You
want heavy metal testing, so a lot of these that
have come from China and other countries are contaminated with
lead and other heavy metals, so you want the certificate
of analysis to demonstrate there's no heavy metals there. You
want sterility testing, so they've confirmed that it's sterile, it
doesn't contain bacteria or anything. And finally, you want to
(45:30):
check the certificate analysis, which should list the batch number
and the lot number against the one on the thing
you're injecting or else. Right, it could just be referring
to some other one that was tested years ago and
I know that sounds insane, and maybe that, more than
anything else, is going to convince people not to use
these things. But I do think if all of these
pieces are in place, you may be okay. I would
(45:53):
not recommend long term use, though, because we really just
don't know the effects, and I've got I am quite
concerned about allergy and autoimmunity with repeated dosing. All right,
Emily talked a lot here. What's your one thing about peptides.
Speaker 4 (46:07):
Don't inject something in yourself that's not FDA proved just
because it worked on a rat.
Speaker 2 (46:13):
That's a good thing.
Speaker 5 (46:15):
What about you.
Speaker 2 (46:17):
I'm not ready to give up on this, but there's
some serious snake oil vibes here.
Speaker 5 (46:21):
Fair enough?
Speaker 4 (46:22):
All right, that's enough about peptides. Possibly too much, who knows.
Stay tuned after the break for our listener mailbag.
Speaker 8 (46:34):
Hi, Emily and Perry. This is Eric from Cambridge, Massachusetts.
I'm forty four to keep hearing about the so called
AMEDE click. You know, like in your mid forties, you
wake up one day and everything feels harder, Workouts just
don't work way creeps up, sleep gets weird, and recovery
just takes forever. Is this actually a thing or just
a mix of lifestyle changes, stress and not moving as
(46:56):
much as we used to. What's actually happening like hormonal
metabolically around the stage? Should I start wearing my pants
higher now?
Speaker 2 (47:03):
All right? So as a forty six year old man, boy,
does this question resonate with me? It's referring just so
everyone knows this forty four is referring to a study
that appeared in Nature Medicine of about one hundred people,
if I'm remembering correctly, It across a range of ages,
and it measured hundreds and hundreds of things in their blood,
you know, DNA methylation and all these things that are
(47:26):
supposed to change with age. And what they were looking
for is like, is there a linear decline in any
of these things over time or in all of these
things over time? That was the expectation. What they actually
found was that there's kind of a linear decline over time,
and then a more abrupt decline at around age forty
four that then kind of levels out, and then another
abrupt decline at age sixty. And you know, this has
(47:48):
gotten sort of blown up to be like these are
the cliffs, like age forty four in age sixty. That's
the baseline. Emily's rolling her eyes. What's the truth, Emily?
Speaker 4 (47:56):
I mean, I think there is almost nothing in biology
that falls off a cliff like this, like we have.
There are so many things where people quote them as
falling off a cliff. Your fertility falls off a cliff
at thirty five, this and that, like fundamentally that it's
not usually how biology works. This is also not, in
my view, a large enough sample size to like really
(48:17):
sort of definitively draw.
Speaker 5 (48:18):
Some kind of cut off in this way.
Speaker 4 (48:21):
So I guess for me, like my prior is everything
just gets worse slowly over time, and I'm not sure
I update very much on that prior. Based on this
fairly limited data, it is true that as we age,
everything gets worse slow decline.
Speaker 2 (48:37):
I have one other thought, okay, which is that this
is based on personal experience, that this is the age,
like the mid forties, when our kids are kind of
old enough to fend for themselves a little bit more,
and I like we all start kind of venturing out more.
Like I'm doing more activities. I'm like playing golf and
I'm lifting weights, which I didn't do before, and I'm like,
(48:59):
definitely injuring myself, and I wonder if it's just actually
the fact that like we're doing, we're actually doing a
little bit more than we would have used to. I
don't know.
Speaker 4 (49:06):
Yeah, this is the age where all of the men
in my I am also forty six, and all of
the sort of men in my social group have decided
to like start playing soccer and lacrosse again. And like,
you know that somebody's like, I'm going to play lacrosse.
You know, the next time you see them, they're going
to have a broken foot, And it's just like really
really consistent exactly.
Speaker 2 (49:26):
That's the actual cliff.
Speaker 4 (49:28):
I don't think that there is an age cliff in
this way, but the fact that as you age through
your mid forties things start to feel harder, like that's
that's true, and it's probably a time people have to
think more about, you know, how to prioritize their sleep
and so on.
Speaker 2 (49:45):
I do have a secret peptide that only I know
that stops the aging cliff, but you have to subscribe
to my like.
Speaker 5 (49:52):
And subscribe, like and subscribe.
Speaker 4 (49:54):
I had one mail bag follow up from last week
that I just I want for the purposes of being
honest with our listeners. So in last week's episode, the
question was asked, you know, what is something you do
that's not based on evidence? And I said, you know,
everything I do is based on evidence. And at dinner,
my husband, Hi Jesse, listen to it, and dinner was like,
(50:15):
I can't believe you said that. So much of what
you do is not based on evidence, and so I
just wanted to say that. I then started reflecting on
some of my behaviors, and I think he may be right. So,
for example, I'm having some sciatica and so I am
now routinely using a machine that like electrically stimulates the
(50:39):
gluten muscles to try to fix my saiatica. And I
do have to admit I don't think that's based on evidence.
So I apologize for not coming up with that last week.
Speaker 2 (50:51):
An immense amount of transparency and honesty from the Wellness
Actually podcasts, separating us from all other people in this
space who never back down from anything they say.
Speaker 5 (51:03):
Ever. All right, that's it for us for today.
Speaker 4 (51:08):
Stick with us next week when we'll ask what's the
deal with cold plunges and saunas. Wellness Actually is produced
in association with iHeartMedia, our senior producer is Tamar Abishai.
Speaker 5 (51:20):
Our executive producer is Jennifer Bassett.
Speaker 4 (51:23):
Our theme music is by Eric Deutsch, and our content
is for educational purposes only.
Speaker 2 (51:28):
If you like the show, help other people find us,
leave a rating and review on Apple Podcasts or your
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the show. Don't give the TikTokers all the power, and
don't forget we want to hear from you. Head over
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for our mailbag or suggest a topic for a future show.
Speaker 5 (51:48):
We'll let the influencers have the last word.
Speaker 7 (51:50):
I've gotten a ton of questions about what a peptide
even is, so let me make this stupid simple. Peptides
are short chain amino acids. The fragments are protein. They're
not steroid or drugs or some fairy dust that some
influencer talks about. So imagine your body is like my
nine eleven turbos. Now imagine somebody handed you the upgrade file,
the tuning file that gets your car to use all
(52:11):
the stuff that it already has.
Speaker 2 (52:13):
But forgot was even there.
Speaker 7 (52:14):
That's what a peptide is. It's not forcing anything and
saying hey, you know all this hidden horsepower.
Speaker 2 (52:20):
Yeah, do that.
Speaker 7 (52:21):
Peptides are like voice commands for your biology.
Speaker 2 (52:24):
They walk into the pit crew of your body and
they say, fire
Speaker 8 (52:27):
Off the factory.
There's a new peptide that literally burns fat off of
your body.
Speaker 2 (00:04):
At the same time it suppresses your owner.
Speaker 3 (00:06):
Peptides are one of the best ingredients you can use
for anti aging.
Speaker 4 (00:09):
Do not sleep on peptides.
Speaker 5 (00:11):
Peptides are the eight Girl of the year, and for
good reason.
Speaker 1 (00:13):
Well that's the thing about peptides. To the wolverine stack,
I don't know. If you ever get injured, get immediately
on BP one, five, seven, and TV five might.
Speaker 6 (00:20):
Help you improve your God, help the tone, texture of
your use fine lines and ring, possibly restore your where's
your natural growth? One?
Speaker 3 (00:27):
So there's truly a peptide for everything.
Speaker 2 (00:30):
Emily, are we in over our heads here?
Speaker 5 (00:32):
Maybe a little bit? How many peptides did you have
this morning?
Speaker 2 (00:35):
Are you ready?
Speaker 4 (00:36):
Well?
Speaker 2 (00:36):
I've had thirty, but it's clearly not enough. It's not enough.
Speaker 5 (00:41):
Did you have your CJC twelve ninety five?
Speaker 7 (00:44):
Oh?
Speaker 2 (00:45):
You know what, that's the problem, because that's the one
I still have my existential sense of dread, and I'm
pretty sure that's the key to eliminate that.
Speaker 4 (00:56):
I'm Emily Astro, I'm an economist and a data expert, and.
Speaker 2 (00:59):
I'm very Wilson. I'm a medical doctor.
Speaker 4 (01:02):
It's Thursday, February nineteenth, twenty twenty six, and this is wellness.
Speaker 2 (01:06):
Actually, because you're getting a staggering amount of health and
wellness information nowadays from every source imaginable, and some of
it is awesome and some.
Speaker 4 (01:16):
Of it is well actually both Fortunately we are both
people who know how to read studies, how to parse
the data, and can tell you what's worth thinking about
and what you can safely ignore.
Speaker 2 (01:29):
But before we dig in, a note that this podcast
is for educational purposes and should not be construed as
medical advice. We don't know your unique situation, so talk
to your doctor for personal health decisions.
Speaker 4 (01:40):
This week we're asking what's the deal with peptides, and
then we'll get to your question of the week. But
first let's do the health news roundup after the break.
Speaker 2 (02:02):
Hey, just a quick note from the future here. The
following conversation about mRNA flu vaccines was recorded before the
FDA reversed their stance. That's good news for everyone, as
you'll soon understand why, but bad news for our producer Tamar,
who had to add this cavea at the eleventh hour.
This is what keeping up with the news looks like,
and I think as you'll see the mere idea that
(02:23):
something is being discussed on the wellness actually podcast has
the effect of moving policy on a national scale.
Speaker 4 (02:31):
All right, Perry, So, first piece of health news for
the week is Maderna has a Phase three trial of
an mRNA flu vaccine, but the FDA has declined to.
Speaker 5 (02:44):
Review their results.
Speaker 4 (02:45):
There's been a lot of talk about this. I think
it's pretty confusing for a lot of people.
Speaker 5 (02:49):
Perry.
Speaker 4 (02:50):
Can you break down what is going on, why people
are upset? Where we go from here?
Speaker 2 (02:54):
Yeah, I mean, to be honest, this is pretty weird,
this is unusual. So why do we need an mRNA
flu vaccine? I mean the argument here is that our
traditional flu vaccines, which are those egg based vaccines, take
about six months to make, and that means you're always
sort of trying to like stay ahead of the flu
the flu eight ball, right, like, you start guessing what
(03:14):
the flu strains are going to be in the future
to grow up your vaccines. mRNA flu vaccine in theory,
can get spun up in a couple of weeks. That's
the benefit of mRNA technology. You could potentially even like
in real time, keep up with the flu strains. That
are coming out, so there's definitely a reason to do
this kind of study, even though we have existing flu vaccines.
This vaccine that Maderna put out, they had published already
(03:38):
several studies about seven thousand patients each demonstrating safety. But
this forty one thousand patient trial was for efficacy. Does
it prevent the flu compared to not a placebo but
the current active flu vaccine, one of these egg based vaccines,
and in fact, the rates of flu were significantly lower
with the Maderna vaccine. They submit that data to the FDA,
(04:00):
and in theory, an FDA advisory panel will review it,
assess it for safety and efficacy, make a ruling that
the FDA then decides on. This did not happen. The
head of the Vaccine Division essentially of the FDA, guy
named Na Prosad, apparently according to New York Times, unilaterally
decided not to review this data at all, so not
to bring it to the peer review group in the
(04:22):
first place. His rationale was that the dose of the
normal vaccine they gave was not high enough for older
people who's who do better with a higher dose, so
it was like not a good enough comparators. The argument.
Here's the problem. If you're a big pharmaceutical company, generally
you go to the FDA and this is what Madarna
(04:43):
did before you do the trial, and you say, hey,
here's our design, here's our control group, here's our analysis.
Are you okay with this? Because you don't want to
spend two hundred and fifty million dollars if the FDA
is going to say they're not okay with this, right,
So they did that. They went to the FDA. The
FDA said, sure, run your trial. You know, this looks
like a good design. And now apparently one person, although
(05:06):
obviously who knows what's going on, has after the fact
been like, no, you know, moving the goalpost. This is
like sort of classic Lucy picking up the football situation.
Speaker 4 (05:17):
Yeah, I mean it is important to hit on the
top point of like why we would want this vaccine,
And I actually think it's particularly interesting in the context
of this most recent flu season where the flu vaccine
was very poorly matched to the circulating flu strain because
they guessed what the circulating strain would be six.
Speaker 5 (05:34):
Months out and they were not right.
Speaker 4 (05:37):
And the promise of the mRNA version of this is
you wouldn't have to guess six months out, you could
guess a month out or two months out, and you
might get much closer. And so I think there's a
lot of value here making the fact that now it
seems like this just won't happen both objectively bad. In
addition to this process seeming like this definitely isn't the
(05:58):
process that we would like, we're already starting to see
companies talk about, you know what I want to do
vaccine innovation now if there's no way it's going.
Speaker 2 (06:06):
To mRNA innovation in general. And you know, m r
and A technology is not just for vaccines. There's there's
m RNA anti cancer therapies and stuff that are getting
held up by this, and it does feel somewhat ideological.
I think all people are asking is like, just do
the normal process, like just submit the data for the
standard peer review that every other drug gets through. That
it's not happening.
Speaker 5 (06:27):
It is a holdover from COVID.
Speaker 2 (06:29):
All of society has long COVID. Right now, basically, all right,
let's stick with the FDA. Emily, maybe some better news.
I'm curious what you thought of this. The FDA had
removed some warnings that appear on hormone replacement therapies for
women who are perimenopausal or postmenopausal. In the past, those
(06:51):
medications had warnings on them that they could increase the
risk of cardiovascular disease, breast cancer, or dementia. Those warnings
are now removed. Good bad.
Speaker 5 (07:01):
I think this is great news.
Speaker 4 (07:02):
I mean, so hormone replacement therapy is really beneficial for
a lot of people in perimenopause and in menopause. It
can improve just quality of life tremendously lower symptoms which
can be really debilitating. There was a large trial decades
ago which suggested that there could be some risks from
(07:24):
hormone replacement therapy, but as people have better understood that
data and gotten follow up data, it has seemed pretty
clear that the risks that were identified in that trial,
which were mostly about cancer, in fact, are not things
that we should be concerned about for the vast majority
of people who would be treated with these medications, and
(07:44):
so we've kind of overtime clawed back towards a view
that actually HRT should be prescribed more that can be
very beneficial, and the removal of these boxed warnings is
the sort of the next step in that. So My
hope is that this will encourage more people who could
benefit from these therapies to be on them. So I
thought this was a response to evidence, and a good
(08:06):
one at that are so.
Speaker 2 (08:08):
Good the FDA gets it right from time to time.
I want to move on to a bit of happier
news something. You know, I've seen this story before, but man,
I always love it. The Olympic village condom situation. So
the New York Times reported that the Winter Olympics village
(08:30):
in Italy they ran out of ten thousand condoms within
three days. To put that in perspective, there are about
three thousand athletes in the Games. That's a lot of condoms.
Speaker 8 (08:45):
A lot.
Speaker 2 (08:45):
I just have to say. It must be fun to
be in like the best shape of your life.
Speaker 5 (08:49):
And in Italy, I agree, I mean I do.
Speaker 4 (08:52):
I did wonder whether there was a condom hoarding issue, right,
So you know, my guess is that people mostly before
their events are kind of like laying low, but maybe
they're picking up a bunch of condoms for like after
the event, and.
Speaker 2 (09:06):
Oh do you think and they've got that like overly
ambitious like I'm gonna need twenty.
Speaker 5 (09:11):
What if I get a gold medal.
Speaker 4 (09:13):
I'm gonna need a lot of condoms for all of
the demand that's going to be coming in after my medal.
Speaker 2 (09:18):
So I was debating this with some people. You think
that you are outspeaks somewhat euphemistically. You think you are
not using the condoms before your event.
Speaker 1 (09:29):
Don't.
Speaker 2 (09:30):
And I'm wondering if there's some events, like maybe biathlon
or like some of the precision events, where you should
be using the condoms more beforehand.
Speaker 5 (09:39):
It's an interesting thing.
Speaker 4 (09:40):
Yeah, I I in my mind, I have the endurance
events where I do think you probably don't want to
be using the condoms before, but.
Speaker 5 (09:48):
I maybe the precision maybe like curling hills.
Speaker 4 (09:50):
You out curling, yes, curly really clearly curling would benefit
from a pre condom preuse.
Speaker 2 (09:58):
There you go, curlers, let us know. Hit us up.
We want to know what your strategy is.
Speaker 5 (10:04):
I really, really really do.
Speaker 4 (10:07):
That's it for the health news of the week. Next up, peptides,
but first.
Speaker 2 (10:11):
A break, Welcome back to wellness. Actually, so, what's the
deal with peptides? Emily? This is like a big topic.
There's so much talk about this on social media. It's
(10:31):
nearly overwhelming.
Speaker 4 (10:33):
I was waiting for the airplane yesterday for a flight home,
and I opened up my Instagram and the first thing
I saw was someone who had two side by side
pictures of her face, and it was like, it was like,
this is what happens after twelve weeks on peptides, and
she looked better. I mean, I don't know that that
particular person. I have a lot of issues, but the
(10:54):
point is that you cannot open social media without hearing
about peptides. I would like us to start this by
just demystifying a little bit, you know. When I think
about peptides the thing, at least before I did some
more research for this episode, the first thing that often
comes into my head is Demimore in the substance, you know,
(11:14):
where she takes something and then she like turns into
a different person and then slowly decays over time. I
don't think that's what it is, but my concern is
that for many people, we're close to that in our
understanding of peptides is just this seems like a crazy
thing with a lot of crazy names that people are
yelling about on Reddit.
Speaker 5 (11:33):
So can you just like anchor us in the biology
of what is this?
Speaker 2 (11:39):
Yes, yes, it does not make hot young women pop
out of your back, at least not yet.
Speaker 4 (11:46):
We haven't rounds of peptide for that is my guess.
Speaker 2 (11:50):
Let's talk about that. Okay, So the first thing you
have to know is what a protein is. So protein
is the building blocks of our bodies. And protein are
composed of little building blocks which are called amino acid.
There's about twenty that humans use in our proteins, and
they're all different, but they all stick together, just like
(12:11):
lego blocks all do. Right. They have one end and
the other and they kind of fit together. And you
can take those twenty amino acids and combine them and
any combinations that you want to make various proteins. Now,
proteins can have, you know, thousands of amino acids. They
can be very very complicated. Peptides are little pieces of proteins,
(12:32):
and the definitions vary, but most people say that peptides
are somewhere south of fifty amino acids. So you're talking
much much smaller than a protein, but you're still using
those same twenty amino acids. And just to explain why
Reddit and Instagram like has an explosion of all these
things with you know, these crazy names and numbers attached
(12:55):
to them. If you want to do the math. Okay,
if you have twenty amino acids that you can combine
into a chain of fifty, the possible combinations, and I
had to get out my scientific calculator for this, the
number of different peptides you could create is the same
roughly as the number of atoms in every star in
(13:18):
our galaxy. Okay, there is a nearly infinite possibility of
the number of peptides that are out there.
Speaker 4 (13:28):
Okay, so we've got these peptides, potentially an infinite number
of them. But I think that the question is why
would having more.
Speaker 5 (13:37):
Of some peptide.
Speaker 4 (13:38):
I understand, we have amino acids, they make peptides, they
make proteins.
Speaker 5 (13:41):
We need those.
Speaker 4 (13:43):
Why would supplementing myself with some peptides have any impact
at all on anything?
Speaker 2 (13:50):
Oh? Sure, Well, so peptides. You know, if you have
a chain of amino acids, what's going to happen is
they're going to fold into like some kind of shit
based on their chemical nature. So these are not like
a long stack that's just aligne based on what the
amino acids are. They kind of fold and shape into
like little globby shapes, which is how your body signals
(14:15):
to do stuff in a lot of ways. So there
are receptors for different shapes on your cells, and different
peptides at least purportedly will stimulate certain receptors, and those
receptors tell your cells what to do. So it's almost like,
you know, you can imagine a key and lock analogy
or something. You have these locks on your cells and
you're trying to inject something that's going to form the
(14:36):
key to open the lock. That's the theory at least.
And a lot of these peptides, while based on proteins
that you can ingest or that exist in your body,
not all of them are you know, some of them
come from animals, some of them are completely synthetic.
Speaker 4 (14:54):
And so the ideas if I had more of some
of these peptides, I could encourage my cells to do
more of something that I want. So I think a
good example that probably anchors for people is the glp
ones are peptides.
Speaker 2 (15:06):
Yeah, classic, so.
Speaker 4 (15:07):
Smaglutide, t receepetite, these like things that people are taking
for weight loss. Those are peptides They are injected and
then they are encouraging something that then causes you to
be less hungry and have all kinds of other impacts.
But it's just a it's just a peptide to try
to get your body to do more of something which
it might do otherwise, but you.
Speaker 2 (15:28):
Want more of it exactly. And just to give a
sense of like the diversity of peptides, I've told you
there's infinite, but because the shape is really what dictates
the function of molecules in your body. Here's some other examples.
So glp ones you said, aspartame the artificial sweetener, okay,
like in diet z. Yeah, I'm not sure which one
(15:49):
is in Die Cooke, but yes, like you know the
one that people actually a lot of wellness influencers are
worried about aspartain is a peptide. It's two amino acids
stuck together. They just happen to make a shape that
stimulates the sugar receptor on your tongue. So it just
like makes you think it's sweet, but it's not. It's
just a peptide. B venom for example, the maion protein
(16:09):
and b venom is called meltin and that's a peptide.
So that can be something that really hurts when you
inject at for example, right, and so one of my concerns,
and actually i'd like to play you a clip, is
people suggesting that peptides are really safe because of their
sort of nature of being something like a protein. So
(16:30):
take a listen to this.
Speaker 6 (16:32):
Peptides are sequences of amino acids. And why is that important?
Because your body recognizes these, it can break them down.
They're called metabolites, and it can get rid of the waste.
When we put chemicals, synthetics, and pharmaceuticals into our body,
there's no natural way for our body to break them
down and get rid of them.
Speaker 2 (16:48):
So emily here we have you know, someone be like, hey,
these are just amino acids, Like your body knows what
to do, that therefore safe. What do you think.
Speaker 5 (16:59):
That doesn't sound right to me?
Speaker 4 (17:01):
I mean, I think you know there the fact that
something is naturally occurring in the world and is an
amino acid definitely does not mean that it is safe.
Speaker 2 (17:09):
It clearly doesn't. Right, Like snake venom has peptides in it, right,
There's lots of things. But I think people one of
the reasons that peptides are exploding, and actually one of
the regulatory reasons you can get your hands on these
things even is because of this idea that like, well,
they're just made of amino acids after all.
Speaker 4 (17:29):
Right, all right, so let's talk about whether these actually
matter for anything.
Speaker 5 (17:34):
And I actually want to start with a place where.
Speaker 4 (17:36):
I think the evidence is the best, which is in
the space of collagen. So I hear people talk about
collagen peptides both for your face and for your joint health.
So this comes up actually a lot in endurance sports.
People talk about, you know, you like, I need my
joints to not be so elderly and creaky, and so
I should take these collagen peptides in a lot of
(17:58):
endurance sports drinks.
Speaker 5 (18:00):
It's a thing.
Speaker 4 (18:01):
And so my sense is that the evidence on this
is at least reasonably good in the.
Speaker 5 (18:08):
Case of your skin.
Speaker 4 (18:11):
So we have some meta analyzes of trials in which
you know, using collagen peptides, typically in a kind of
topical way, can have significant improvements in your skin hydration
and elasticity. Now, okay, in that particular meta analysis, there
was there was a subtlety, which is that when you
(18:32):
only looked at studies that were not sponsored by industry,
the effects were not there so capitalism. But I'm curious
whether you, like, if you were interested in improving your
already lovely skin elasticity, would you use a collagen peptide.
Speaker 2 (18:48):
I mean, maybe I don't care that much about it,
but you know whatever, I'm a I'm a forty six
year old man, so I know that there are some
there's some different opinions here. I mean. The interesting thing
aboutologen peptides is that they're basically the only peptide to
exist in a regulatory landscape that makes it easy and
safe to get because the FDA has recognized that collagen
(19:10):
itself is safe. They call it generally recognized as safe,
which means you can be a supplement company and you
can put collagen in a pill and you can give
it to people. Collagen peptides all it is is they
take collagen and they digest it with an enzyme. So
collagen is a big protein with you know, thousands, literally
thousands of amino acids, and then they just digest it
(19:31):
down into kind of manageable pieces, very similar honestly to
what your digestive system does when you eat a big protein.
But that said, the collagen peptides are because they're smaller,
absorbed through the skin, a little bit better, absorbed through
the GI tract a little bit better, and you're delivering
in that sense, you're delivering some of these proteins, some
of these constituents of the stuff that makes your skin,
(19:54):
you know, firm and elastic, directly to the site that
you want them to be delivered. And to me, that
seems fine. You know, this is one of those things
I tell people Listen, it's not terribly expensive. If you
feel like trying to try it, you know, try to
be honest with yourself if you think you really look
better if you don't, save your money.
Speaker 5 (20:11):
Yes, save your money.
Speaker 4 (20:12):
Perhaps good advice in general in everything we hear about
on social media. So beyond collagen, I think there are
actually a couple of other things where a couple of
other FDA approved peptides which treat actually.
Speaker 5 (20:26):
Someone unusual things. So one of them is for.
Speaker 4 (20:33):
Tanning and one is for improving female sexual desires.
Speaker 5 (20:38):
I get that right, sort of.
Speaker 2 (20:40):
Yeah, the one for tanning called Atha melanotide. It's not
FD approved to get you tan. It does, but it
does get you tan. It's approved for a very rare
condition called erythropoetic proto porphyria, very few people have, but
it does stimulate the melanin receptor, which is what makes
(21:01):
you tan, and so people who receive this drug do
get tan. And it's worth thinking about just because there
is a pathway for peptides to go through the same
approval process that every other drug has to go through,
the same purity standards, the same testing, the same manufacturing practices,
and they can do really interesting things like it's true
at the female hyperactive sexual desire disorder, which emily this
(21:24):
we definitely need to do a whole show about this
because it's fascinating. That's a peptide product called vleisi which
was approved to treat this condition. It does apparently increase
sexual desire in women. It also causes nausea in forty
percent of people who take it, which I don't know
how those two things are compatible, but apparently they are.
Speaker 5 (21:47):
Well, you don't know, it could be the sixty percent
of people who are not nauseous. You know, it's straight
up fair enough.
Speaker 2 (21:52):
Yeah, it's your flipping an interesting coin there, And of
course we should. You mentioned already the GLP one receptors
aretides and insulin, which is you know, maybe saved more
lives than any other injectable drug that we've ever created.
Is also a peptide product. So there is a pathway.
But I think there's a lot of people who are
(22:13):
trying to kind of jump that evidence gun and potentially
taking on more risk than they know that they are
taking on.
Speaker 4 (22:20):
What about the evidence on joint pain, Most of this
evidence is in athletes, some of it's in older people.
Speaker 2 (22:26):
Yeah, it's there, it's there. I mean, so we do
have another meta analysis, and for everyone, a meta analysis
is just a study of studies. So it's a study
that aggregates data from multiple other studies that have been
done to try to kind of average out the variability
and things like that. There was some evidence in this
meta analysis of fifteen randomized trials of collagen peptides for
(22:49):
joint pain, twelve of which were in athletes that showed
some improvement in joint pain, that there was really no
evidence for muscle building, which is the other thing that
people sometimes suggest this being u used for. Again, one
of the problems we have when the outcome of a
trial is subjective, like pain or fatigue or even depression.
Speaker 5 (23:11):
How your skin looks.
Speaker 2 (23:13):
How your skin looks is that it is very susceptible
to what we call placebo effects, like the idea that
you're taking something. Now randomized control trial is going to
have placebo controls. But just even because you have a
placebo doesn't mean people can't figure out what they're getting.
Sometimes they taste a little bit different, they look a
little bit different, things like that. So you know, again
(23:35):
for joint pain, it's like it's relatively safe, it's not
going to hurt you. It's they're non toxic. If it helps,
that's great. I mean, I don't even care if it's
a placebo, right Like, if it helps, and then feel
like it helps, you feel like it helps, it helps,
go for it.
Speaker 8 (23:49):
Yeah.
Speaker 4 (23:49):
I mean this is an example of a place where
I think we sort of bring together, like often what
we're looking for, and we try to argue for causality
the question of like is it biologically plausible? I think
the answer in the collagen peptide case is yeah, it's
biologically plausible that.
Speaker 5 (24:05):
You know, this could have some this could make some difference.
Speaker 4 (24:08):
And then we're looking for, you know, do we have evidence,
either randomized evidence or even observational evidence. But here it's
randomized that suggests that we do see some impacts.
Speaker 5 (24:19):
I will say I take away from this like this
is small.
Speaker 4 (24:22):
Yeah, there are many other things one might do to
address joint pain, like strength training and other things where
collagen could be like a little helpful, but.
Speaker 5 (24:30):
Is probably not the be all and end all.
Speaker 4 (24:33):
And sort of similarly, my guess is the overall variation
in skin elasticity across people is much greater than the
treatment effect of a collagen peptide. Like when you see
someone on the Internet and their skin is amazing and
they tell you they took collagen, I'm telling you it's
that they have good genetics and or are using a filter,
(24:56):
not that they are taking collagen and.
Speaker 2 (24:58):
Are really good at makeup. When I was looking at
all the peptide stuff on Instagram and things, these videos,
all I was like, oh my god, these people are
just beautiful. Like that's the that is the requirement. Apparently
to be an influencer is to like look really good
on camera, you know, which is why I'm glad this
is an audio podcast. No one has to look at
(25:19):
my unfiltered face.
Speaker 5 (25:22):
Everyone will love it.
Speaker 4 (25:23):
Okay, so let's talk about the sort of third piece
of the peptide conversation, which is the idea of using
injected peptides for like longevity, wound healing.
Speaker 5 (25:38):
And this is a much.
Speaker 4 (25:39):
Bigger space than the narrow like I'm taking some mythologen
to improve my face. It's like, you know BPC one
fifty set. It's there's a thing called the wolverine stack. Basically, Perry,
there's a thing called the wolverine stack. And I guess
do we want it?
Speaker 5 (25:55):
Say more?
Speaker 2 (25:56):
Well, okay, Emily, let's take it from the highest authority
in the land, Joe Rogan himself.
Speaker 1 (26:04):
Well, that's the thing about peptides to the wolverine stack.
BP one five seven and TV five hundred.
Speaker 7 (26:09):
I don't know.
Speaker 1 (26:09):
If you ever get injured, if you ever get injured,
get immediately on BP one five seven and TV five hundred.
Speaker 2 (26:14):
I didn't hear about TV five hundred.
Speaker 1 (26:16):
What's that one thymuson BETA five hundred. Yes, in conjunction
with BPC one five to seven, it is a phenomenal
stack and just really helps injured.
Speaker 8 (26:25):
I don't know.
Speaker 2 (26:25):
They called it the wolverine that's.
Speaker 1 (26:26):
What they call it. The wolverine staling. Yeah, because you
heal incredibly well, like you like quickly, I was talking
to pro football player pulled his hamstring. It's like, dude,
I shot that right into my hamstring for two weeks
and I was right back on the field. Wow, I
was like, that's nuts.
Speaker 2 (26:39):
So, first of all, Joe Rogan, Ben Affleck, Matt Damon
in that clip, I mean, we are really blowing against
the wind. I mean, I don't know that we can compete.
Speaker 5 (26:50):
No, totally not. I mean that, yeah, all right, but.
Speaker 2 (26:53):
Let's let's let's I think BPC one fifty seven because
of Joe Rogan honestly, and the Wolverine stack is BPC
one fifty seven combined with TB five hundred, which is
another injectable peptide. I think it's really emblematic of the space.
And so no, we are not. I have to apologize
to our listeners. There are like hundreds and hundreds of
marketed peptides out there. We just simply can't get to
(27:17):
all of them and like whether they work and how
they work. But I think there's some real big principles
here that BPC one fifty seven sort of teaches us.
So let's start there and kind of kind of walk
through it totally so BPC one fifty seven, this is
a peptide that was initially isolated from human gastric juices,
(27:38):
which is weird, okay, but fine.
Speaker 5 (27:41):
You know, as you said, you can get peptides from anywhere.
Why not from your ass rod juices?
Speaker 2 (27:47):
Sure? But you know, because it's being promoted for healing
and everything. You kind of I was like, oh, it
must have been isolated from like healing cells or something whatever,
But you know, hey, the gastric mucosa is a hostile environment,
so so maybe there's some biologic plausibility there. The data
for BPC one fifty seven is essentially entirely in mice
(28:08):
and rats, So you injure a rat like use sever
This is cruel a little bit, but this is how scientific.
Speaker 5 (28:16):
And rats and mice in is corol.
Speaker 2 (28:17):
So I know, so trigger warning for pet rat owners.
They will like sever part of a rat's achilles tendon
and then you know, they either inject this stuff or
they inject a placebo and then they see how fast
the achilles tendon heels. And some of those studies and
mice and rats do show accelerated healing with PPC one
(28:38):
fifty seven.
Speaker 4 (28:39):
Okay, I just want to pause on the question of
mice and rat studies because I feel like a tremendous
amount of the data that we have in the world
about all kinds of different treatments come from mice and rats.
Because mice and rats are really easy to experiment on.
You can do all kinds of stuff with them, like
cut their achilles and do other things, and look in
(28:59):
their brains and kill them and do all kinds of
things which may be said but are effective for learning.
And we always then have the question of how do
we take the evidence from mice and rats into humans.
And you know, there there I think are really good learnings.
But someone said to me the other day, you know,
if we were mice, we would have solved like everything,
(29:20):
because actually in mice, you know, you can really titrate
and be careful, and there's a lot of things that
work in mice. But then when we bring them into humans,
it doesn't work, or the effect size is totally different,
or just this doesn't port over.
Speaker 2 (29:33):
Yeah, we're just not the same creatures. But there's even
bigger issues than that, particularly when it comes to the
longevity space, because mice and rats don't live as long
as people in their natural states. You know, mice might
live a year or two, rats might live a little
bit longer. But you know what, in these research studies,
they're not letting these mice live to a ripe old age, right.
(29:56):
What you do is, you know, you do your little
Achilles tendon thing, and then you watch them for a
couple of weeks as they heal, and then you the
euphemism is sacrifice the mice. You know, humanly, that's the euphemism.
That's the euphemism is sacrifice. You kill the mice in
as humane way as possible, and there are protocols for that.
And then and then you know, you can extract their
(30:18):
organs and look them under the microscoop and do all
that stuff. So even if we're like, oh, yeah, this
appears to heal Achilles tendons, the larger scale questions of
like what happens if you're doing this repeatedly on a
weekly basis for years and years and years, like, we're
not even close to knowing that, And there are some
concerns here. So BPC one fifty seven. Thanks to the mice,
(30:40):
we know a little bit about how it might work.
Aside from the general magic of being a gastric juice
peptide BPC one fifty seven appears to bind a receptor
called VEJEFF, or vascular endothelial growth growth factor, which promotes
the growth of blood vessels into tissues. And sure that
makes sense. If you're talking about healing, you want a
lot of blood flow, Like, that's no doubt a good thing.
(31:02):
One of the problems. Actually, you probably can guess the
problem memory, what's wrong if we promote blood vessel growth
into tissues too much?
Speaker 4 (31:12):
I actually I feel like this is like when my
fourteen year old asked me about her biology homework, and
I feel like, no, I don't know.
Speaker 2 (31:21):
Cancer is begging for blood vessels to come into the tumors,
and one of our main therapies to treat cancer is
blocking VEJEF because it turns off that signal that the
cancer saying like, ooh, give me blood, grow blood vessels
into me, and then the cancer starves and dies. And
so there is a theoretical concern that's, you know, ongoing
stimulation of receptors like this could lead to cancer. And
(31:43):
we have no idea if that's true, because you kill
the mouse, you know, a week after you give the injection.
So just something to be aware of there.
Speaker 4 (31:50):
When we look at this particular thing in people, I
would say my read is that, like, we don't have
much evidence in any direction that this is effective in people.
We don't have any randomized control trials, we don't have
a lot of just we just don't have anything.
Speaker 2 (32:05):
Correct, only anecdote, which is unfortunately the problem.
Speaker 4 (32:08):
Yeah, yeah, anecdote is not data. I mean, this whole space,
this Wolverine stack, all of the other stacks.
Speaker 5 (32:16):
The different things, really has the feel of like there's
an interesting potential something to explore based on the animal data,
but nothing in the people data that would say they
should be widely adopted based on efficacy foundation. And then
we are worried about, you know, some of the potential
(32:38):
risks to using such a treatment.
Speaker 2 (32:41):
Absolutely right, and I think that's the prudent point. But
we also have to realize that a there are a
lot of people out there that are potentially suffering with something,
and a lot of times the medical establishment that I
am a part of does a poor job of this. Right,
They've got joint pain, they have something, you know, yes, sure,
they were told to do physical therapy, they're told to
(33:02):
do strength training and things just aren't working. So there's
a desperation there, like this does fulfill a need that
I think some people have. And then there's a whole
group of people, you know, the kind of biohackers who
are like, yeah, yeah, I understand in theory that we
would like to have a large, randomized trial to prove
that this works, but I'm not going to wait for that.
Like this stuff seems great. My buddy says it's great.
(33:22):
This guy online says it's perfectly safe, you know, LFG Like,
let's go, and I'll sort of throw caution to the wind.
And I think as much as we can say, like, well, guys,
I don't know, there's no hard data. It's it's still
going to happen. And so I think, anticipating that this
stuff is out there, we might want to try to
give people some like tools to be able to separate
(33:45):
at least what is potentially safe from what is potentially
not safe, even if we throw evidence out the window.
Speaker 4 (33:52):
Yeah, so I want to start with actually the just
noting that the Okay, so let's kind of back up
there the way we think about peptides. There are some
peptid that people take orally other than some of these
collagen peptides. Generally, oral peptides are totally ineffective because they
break down in your stomach and are not therefore absorbed.
So if somebody is telling you here are some gummies
(34:14):
with this amazing peptide, like that's just a money toilet,
Like you're just putting your money in a money toilet
and flushing it away, correct.
Speaker 2 (34:22):
I think broadly, yes, there are ways to make peptides
more stable in the GI tract. Oral peptide consumption is
basically going to be safe, you know, even if you
are ingesting like b venom.
Speaker 4 (34:34):
Because it's not effective. It's it's safe because it's useless.
Your stomach is eating it.
Speaker 2 (34:39):
Correct, And so so I don't worry too much about people,
you know, wasting their money on things. You know, I'm
a libertarian in that sense.
Speaker 4 (34:48):
No, I will say I worry about that because I
feel like, exactly to the point you had before, which is,
you know, people are struggling with this, they want to
get help, and then online someone's telling them, oh, just
take this gummy be venom and like it's going to
fix all of your of your problems. I actually think
that really gets in the way of people finding solutions
that might actually work for them. So I am more
(35:09):
worried than you are about the kind of I'm buying
this unapproved thing that somebody on TikTok told me about,
even if it is not actually unsafe, although I agree
with you, it's worse if there's a potential safety risk.
Speaker 2 (35:20):
Yeah. I mean, the trick here is being honest with
yourself and really trying to determine whether this thing that
you tried, if you're going to try it, helped you
or not, Like is your life better or not? Is
it worth the expense or not? We think I agree
with you it probably isn't most of the time, Okay.
Speaker 4 (35:37):
But then there are these products that you're injecting.
Speaker 5 (35:40):
So most of these peptides.
Speaker 4 (35:42):
Would be delivered to the extent they could be efficacious
at all. They are delivered through an injection like a
JLP one, But these, unlike the GLP ones, are not
in an FDA approved product category. So generally the FDA
does not approve these peptides, which are made by compounding
pharmacies and are not regulated because the FDA has actually
(36:07):
now said they are illegal to compound. That includes this
BPC one fifty seven and all of these other ones,
and so if you're getting these, they are not from
an FDA proof supplier.
Speaker 2 (36:17):
I think this is such an important point, and I
want to play a clip here about someone who's trying
to talk about safe sourcing of peptides.
Speaker 3 (36:27):
So today you and I are going to have a
little chit chat about where you're getting your peptides from.
There are a couple different ways that you can get
your hands on peptides. One is going to your doctor
and getting a pharmaceutical prescription for its option number two
compound pharmacy. But there are two split offs that come
up when we talk about compound pharmacies. So one is
going to be pharmaceutical grade, human grade, made for human beings.
(36:48):
The other is research grade. This is the one that
I am telling my clients to stay away from. There's
not the same amount of oversight.
Speaker 5 (36:55):
We don't have their party.
Speaker 2 (36:56):
So I really do think because you know, if you're
listening this and you're like, well, I don't know, Joe
Rogan says, BPC one fifty seven is good, Like I
want to get some my hands on some BPC one
fifty seven. It is important to know what the regulatory
landscape is here. Compounding pharmacies are pharmacies that have a
license to mix drugs. That's what compounding is. They can
(37:19):
make their own concoctions under specific conditions, ideally sterile conditions
that they can then sell for injections and things like that.
Compounding pharmacies are regulated at the state, not the federal level,
which gives this whole crazy patchwork of what's legal across
the country. And because you can ship these things from
state to state, it basically is like a lowest common
(37:41):
denominator of what the compounding pharmacy can do. Many of
the peptides that you'll see out there on Instagram are
able to be made in compounded pharmacies, but many of
the most popular ones, as you said, Emily, are not.
So BPC one fifty seven, this Wolverine stack peptide out
of Joe Rogan fame was classified by the f as
a Category two substance, which is one that has significant
(38:03):
evidence for harm. And compounding pharmacies are not allowed to
synthesize or create anything that is Category two, where they
lose their license that's illegal. So if you're getting BPC
one fifty seven, you're actually not getting it from a
compounding pharmacy. You're getting it from overseas almost certainly, and
most of it comes from China. So again, BPC one
(38:26):
fifty seven, I think is like the poster child for
this set of problems. It's marketed aggressive. It's got a
I mean Wolverine stack like that is amazing, totally awesome,
like I'm a superhero fan, like that is great marketing.
It's got really impressive influencers talking out like two with that.
I mean, I would do it. I would do it
if you show me. You've got these impressive influencers talking
(38:48):
about it. You have, you know, anecdotal evidence from anecdotal stories,
i should say, from people saying how great it is.
But it's actually like deemed unsafe. You have to source
it from some external kind tree and we have no
idea what its actual effects are. And that's sort of
the space right now. It's like it's pretty much the
wild West, and when it comes to eating something, you know,
(39:08):
I'm more experimental when it comes to injecting things into
your body, like you don't really want the wild West.
Speaker 4 (39:13):
Yeah, I mean, there are all kinds of examples in
the past of things.
Speaker 5 (39:18):
That were injectable that turn on bad.
Speaker 4 (39:20):
I was looking at this Scientific American article from a
number of years ago about stem cells where someone had
like injected some stem cells to try to fix some
eyelid problem and they ended up growing tiny bones in
their eyelid which need to be removed.
Speaker 5 (39:33):
I'm not saying that's going to happen here.
Speaker 2 (39:35):
That is worse than the substance.
Speaker 5 (39:38):
It is somewhat worse. I know you may not have
watched the substance.
Speaker 4 (39:42):
It's pretty much, but I mean, I feel like there
is a general sense that injecting yourself with things it
runs a risk of infection, and it is just a
much more extreme approach to this than say eating something,
which again I don't think that sense in this context
for almost any of these peptons.
Speaker 2 (40:03):
Let me give you two more risks of injecting things
into your body is if we don't have enough Number
one allergy. As you may know, when we eat things,
we have this whole immune system in our gut that
surveils them for allergens and gives us tolerance to the
things we eat. This is why, like Emily, I'm sure
you've talked about it's actually good for little kids to
get kind of dirty and put dirt in their mouths
(40:25):
and stuff like that so that they have less hypothesis
allergic reactions. Right, that's what our gi TRAC does. When
we get what are called antigens, which are peptides or
proteins or other things via another route like the injection
or sometimes the inhalation route, a whole different immune reaction occurs,
and that is an allergen forming immune reaction. It is
(40:46):
worth noting that the first time you get stung by
a bee is not when you have the anaphylactic response
to a beasting if you're allergic to bees, it's the
second time. The first time the allergy starts to get
learned and will up essentially, and then the second time
you get stung you have the anaphylactic shock. As I said,
there's infinite peptides you could theoretically inject into you, and
(41:08):
it is likely that some at the very least will
cause severe allergies in some people. To be aware of that.
Number two is what we call autoimmunity. So your immune
system is this amazing thing that surveils all the cells
in your body and decides is this me or is
this something else? And in general, if you're healthy, it
(41:28):
looks at your cells and says, oh, yeah, this is me.
I don't need to attack this, this is myself. We're okay.
Autoimmunity is when the immune system starts to recognize something
in your own body that is you, but it doesn't
recognize it as you anymore, so it attacks it. And
you know, lupus, for example, is the prototypical like autoimmune
syndrome where your immune system is attacking these various cells
(41:49):
in your body. When you inject a protein into yourself,
you form antibodies to that protein. That is how vaccines work.
When we inject a covid vaccine, antibodies form against the
spike protein and that works because the spike protein is
not you, and so when the immune system sees the
spike protein again, it can attack that. Many of these
(42:12):
peptides are derived from human proteins, and if your immune
system starts to recognize those peptides as foreign, there's a
chance that they might start to attack your own proteins
that contain those peptides as foreign, and that could be
really bad. It could almost do the opposite of what
you want these things to do, right, because you want
these peptides to stimulate this system, and now all of
(42:35):
a sudden you have antibodies that are directly attacking the system.
That could be an issue in the long term.
Speaker 5 (42:40):
It does seem like an issue in the long term.
Speaker 4 (42:42):
Okay, so Perry, I honestly feel like we could just
list all of these peptides that exist in the world
and just talk about why there's no evidence for them.
You know, there's TB five hundred, there's g hkcu. There
are a million of these peptides. And if we talked
about everyone speaking nearly all cases, what we would say was,
(43:04):
you know, maybe there's a little bit of suggestive something
in mice, and there's nothing to say in people. And
there are these risks of injecting yourself with random things,
which you want to be careful about. So I do
want to acknowledge the people who are listening, who are like,
I hear you about this, but it sounds good. I'm
(43:24):
interested in trying. And so if someone came you know,
you're doctor, somebody comes to you and they're like, look,
I'm really interested in trying to inject myself with a
bunch of different peptides. I just feel like it's like,
that's that's for me this week. Is there any way
to ameliorate some of the concerns that you have about
such activities?
Speaker 2 (43:45):
Yeah, I mean, so you know, you're probably not going
to get them from me directly because I don't think
the risk benefit calculus is there. But yeah, just to understand,
let's accept the fact that people are going to do this, like,
you know, we cannot fight the tides.
Speaker 5 (44:00):
The apple that comes to you and ask for some advice.
What's the advice?
Speaker 8 (44:02):
All right?
Speaker 2 (44:04):
Ben? What was up with Geeli? Did you need to
do that?
Speaker 7 (44:06):
Like?
Speaker 2 (44:07):
Was she pressure you? Okay? If you're going to do it, okay,
realize that if someone tells you that they're getting some
of these peptides like GPC one fifty seven from a
compounding pharmacy, they're not. It's not legal, so it's coming
from outside of the US, So be a little skeptical of,
you know, wherever you're getting them from if you are
getting there. And there are places that do a better
(44:28):
job of trying to be reputable in this space, and
what they do is they farm out the substance to
an independent testing laboratory, which issues what's called a certificate
of analysis, which basically says like, we tested the stuff
in here, and yes, it is what it says it is.
The things you're looking for on a certificate of analysis.
(44:49):
Number one is purity. Is it actually you know? Is it?
Is it clean? Is it the stuff you want? You
want basically greater than ninety eight percent purity to feel comfortable.
Number two, you want testing for something called endotoxin. This
is a bacterial byproduct that causes sepsis and inflammation. You
do not want endotoxin in anything you inject into your body.
(45:09):
It's also the thing that causes toxic shock syndrome. You
want heavy metal testing, so a lot of these that
have come from China and other countries are contaminated with
lead and other heavy metals, so you want the certificate
of analysis to demonstrate there's no heavy metals there. You
want sterility testing, so they've confirmed that it's sterile, it
doesn't contain bacteria or anything. And finally, you want to
(45:30):
check the certificate analysis, which should list the batch number
and the lot number against the one on the thing
you're injecting or else. Right, it could just be referring
to some other one that was tested years ago and
I know that sounds insane, and maybe that, more than
anything else, is going to convince people not to use
these things. But I do think if all of these
pieces are in place, you may be okay. I would
(45:53):
not recommend long term use, though, because we really just
don't know the effects, and I've got I am quite
concerned about allergy and autoimmunity with repeated dosing. All right,
Emily talked a lot here. What's your one thing about peptides.
Speaker 4 (46:07):
Don't inject something in yourself that's not FDA proved just
because it worked on a rat.
Speaker 2 (46:13):
That's a good thing.
Speaker 5 (46:15):
What about you.
Speaker 2 (46:17):
I'm not ready to give up on this, but there's
some serious snake oil vibes here.
Speaker 5 (46:21):
Fair enough?
Speaker 4 (46:22):
All right, that's enough about peptides. Possibly too much, who knows.
Stay tuned after the break for our listener mailbag.
Speaker 8 (46:34):
Hi, Emily and Perry. This is Eric from Cambridge, Massachusetts.
I'm forty four to keep hearing about the so called
AMEDE click. You know, like in your mid forties, you
wake up one day and everything feels harder, Workouts just
don't work way creeps up, sleep gets weird, and recovery
just takes forever. Is this actually a thing or just
a mix of lifestyle changes, stress and not moving as
(46:56):
much as we used to. What's actually happening like hormonal
metabolically around the stage? Should I start wearing my pants
higher now?
Speaker 2 (47:03):
All right? So as a forty six year old man, boy,
does this question resonate with me? It's referring just so
everyone knows this forty four is referring to a study
that appeared in Nature Medicine of about one hundred people,
if I'm remembering correctly, It across a range of ages,
and it measured hundreds and hundreds of things in their blood,
you know, DNA methylation and all these things that are
(47:26):
supposed to change with age. And what they were looking
for is like, is there a linear decline in any
of these things over time or in all of these
things over time? That was the expectation. What they actually
found was that there's kind of a linear decline over time,
and then a more abrupt decline at around age forty
four that then kind of levels out, and then another
abrupt decline at age sixty. And you know, this has
(47:48):
gotten sort of blown up to be like these are
the cliffs, like age forty four in age sixty. That's
the baseline. Emily's rolling her eyes. What's the truth, Emily?
Speaker 4 (47:56):
I mean, I think there is almost nothing in biology
that falls off a cliff like this, like we have.
There are so many things where people quote them as
falling off a cliff. Your fertility falls off a cliff
at thirty five, this and that, like fundamentally that it's
not usually how biology works. This is also not, in
my view, a large enough sample size to like really
(48:17):
sort of definitively draw.
Speaker 5 (48:18):
Some kind of cut off in this way.
Speaker 4 (48:21):
So I guess for me, like my prior is everything
just gets worse slowly over time, and I'm not sure
I update very much on that prior. Based on this
fairly limited data, it is true that as we age,
everything gets worse slow decline.
Speaker 2 (48:37):
I have one other thought, okay, which is that this
is based on personal experience, that this is the age,
like the mid forties, when our kids are kind of
old enough to fend for themselves a little bit more,
and I like we all start kind of venturing out more.
Like I'm doing more activities. I'm like playing golf and
I'm lifting weights, which I didn't do before, and I'm like,
(48:59):
definitely injuring myself, and I wonder if it's just actually
the fact that like we're doing, we're actually doing a
little bit more than we would have used to. I
don't know.
Speaker 4 (49:06):
Yeah, this is the age where all of the men
in my I am also forty six, and all of
the sort of men in my social group have decided
to like start playing soccer and lacrosse again. And like,
you know that somebody's like, I'm going to play lacrosse.
You know, the next time you see them, they're going
to have a broken foot, And it's just like really
really consistent exactly.
Speaker 2 (49:26):
That's the actual cliff.
Speaker 4 (49:28):
I don't think that there is an age cliff in
this way, but the fact that as you age through
your mid forties things start to feel harder, like that's
that's true, and it's probably a time people have to
think more about, you know, how to prioritize their sleep
and so on.
Speaker 2 (49:45):
I do have a secret peptide that only I know
that stops the aging cliff, but you have to subscribe
to my like.
Speaker 5 (49:52):
And subscribe, like and subscribe.
Speaker 4 (49:54):
I had one mail bag follow up from last week
that I just I want for the purposes of being
honest with our listeners. So in last week's episode, the
question was asked, you know, what is something you do
that's not based on evidence? And I said, you know,
everything I do is based on evidence. And at dinner,
my husband, Hi Jesse, listen to it, and dinner was like,
(50:15):
I can't believe you said that. So much of what
you do is not based on evidence, and so I
just wanted to say that. I then started reflecting on
some of my behaviors, and I think he may be right. So,
for example, I'm having some sciatica and so I am
now routinely using a machine that like electrically stimulates the
(50:39):
gluten muscles to try to fix my saiatica. And I
do have to admit I don't think that's based on evidence.
So I apologize for not coming up with that last week.
Speaker 2 (50:51):
An immense amount of transparency and honesty from the Wellness
Actually podcasts, separating us from all other people in this
space who never back down from anything they say.
Speaker 5 (51:03):
Ever. All right, that's it for us for today.
Speaker 4 (51:08):
Stick with us next week when we'll ask what's the
deal with cold plunges and saunas. Wellness Actually is produced
in association with iHeartMedia, our senior producer is Tamar Abishai.
Speaker 5 (51:20):
Our executive producer is Jennifer Bassett.
Speaker 4 (51:23):
Our theme music is by Eric Deutsch, and our content
is for educational purposes only.
Speaker 2 (51:28):
If you like the show, help other people find us,
leave a rating and review on Apple Podcasts or your
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the show. Don't give the TikTokers all the power, and
don't forget we want to hear from you. Head over
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for our mailbag or suggest a topic for a future show.
Speaker 5 (51:48):
We'll let the influencers have the last word.
Speaker 7 (51:50):
I've gotten a ton of questions about what a peptide
even is, so let me make this stupid simple. Peptides
are short chain amino acids. The fragments are protein. They're
not steroid or drugs or some fairy dust that some
influencer talks about. So imagine your body is like my
nine eleven turbos. Now imagine somebody handed you the upgrade file,
the tuning file that gets your car to use all
(52:11):
the stuff that it already has.
Speaker 2 (52:13):
But forgot was even there.
Speaker 7 (52:14):
That's what a peptide is. It's not forcing anything and
saying hey, you know all this hidden horsepower.
Speaker 2 (52:20):
Yeah, do that.
Speaker 7 (52:21):
Peptides are like voice commands for your biology.
Speaker 2 (52:24):
They walk into the pit crew of your body and
they say, fire
Speaker 8 (52:27):
Off the factory.
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